UnitedHealth Group

UnitedHealth Group is a diversified health care company with two distinct platforms, UnitedHealthcare for health benefits and Optum for health services, serving more than 100 million people worldwide. The company offers FHIR R4-compliant Interoperability APIs through the Optum platform, providing patient access to health records, claims history, provider directory, and drug formulary data in compliance with CMS Interoperability and Patient Access final rule (CMS-9115-F) and HL7 FHIR standards.

UnitedHealth Group publishes 4 API contracts indexed on the APIs.io network, including Clinical Data API, Drug Formulary API, Patient Access API, and 1 more. Tagged areas include Healthcare, Health Insurance, FHIR, Claims, and Interoperability.

The UnitedHealth Group catalog on APIs.io includes 1 JSON-LD context and 2 Spectral governance rulesets.

UnitedHealth Group’s developer surface includes engineering blog, authentication, and 8 more developer resources.

📡 Profile data on GitHub

30.9/100 thin ▬ flat Agent 24/100 agent aware Full breakdown ↓
scored 2026-11-06 · rubric v0.27.0 · Show this score on your site →

AccessEnterprise

1 published contract

Healthcare Health Insurance FHIR Claims Interoperability Fortune 100

What this lets a business do 1

Business capabilities this provider's published APIs can perform, derived from its own contracts. Browse all capabilities →

Health Information Management

BC-2900

Clinical DataPatient Access

GET /Condition GET /Patient/{id} GET /ExplanationOfBenefit

Kin Score

Kin Score How this is scored →
scored 2026-11-06 · rubric v0.27.0

Composite quality — 30.9/100 · thin

Contract Quality 12.1 / 21

Developer Ergonomics 4.0 / 17

Access Clarity 0.9 / 17

Operational Transparency 1.7 / 11

Contract Governance 1.4 / 10

Discoverability 5.6 / 9

Regulatory Posture 3.0 / 15

Agent readiness — 24/100 · agent aware

Machine-Readable Contract 18 / 18

Agentic Access Contract 10 / 10

Documented Reversibility 6 / 6

MCP Server 0 / 12

Machine-Readable Auth 10 / 10

Idempotency 9 / 9

Stable Error Semantics 0 / 8

Request/Response Examples 7 / 7

Rate-Limit Signaling 7 / 7

Typed Event Surface 0 / 6

Agent Skills 0 / 5

Well-Known Catalog 0 / 4

Consent & Bot Identity 0 / 3

A2A Agent Card 0 / 8

Dry-Run / Simulate Mode 4 / 4

Delegated User Identity 0 / 6

Protected Resource Metadata 0 / 5

Registration Without a Human 0 / 6

Agentic Commerce Well-Known Document 0 / 5

Pagination 5 / 5

Distinct Operations 3 / 3

MCP Tool Quality 6 / 6

Regulatory Posture applies to this provider. Its tags matched the Insurance regime, so Regulatory Posture carries 15 points of the composite. If this regime is wrong for your business, say so on your provider repo — the applicability map is public and we will correct it.

Create-or-Update Ergonomics does not apply to this provider. The published contracts declare no write operations, and a read-only API cannot create-or-update. The facet is excluded from this provider's denominator entirely — not scored zero. A reference or data API is not deficient for being unable to upsert.

The six quality facets above are damped to 85 points between them, because the conditional facet above carries the other 15. That is why each facet's contribution is shown against a damped maximum: raising a quality facet moves the composite by 85% of its nominal weight, not 100%. The full arithmetic is at apis.io/rating/.

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Agent readiness — checks not met, largest first (exact, from this profile):

MCP Server +12 pts — deployment.mode + probe verdict on the mcp/ manifest, not the pointer; an unprobed slug falls back to authorship
Stable Error Semantics +8 pts — OpenAPI $refs a shared error schema across 4xx/5xx responses (verified), else common[].type includes ErrorCatalog / ErrorCodes / DeclineCodes
A2A Agent Card +8 pts — a2a/-a2a.yml manifest, graded on conformance.grade against A2A 1.0.0
Registration Without a Human +6 pts — a `registration_endpoint` in the served RFC 8414 / OIDC discovery document
Delegated User Identity +6 pts — a served discovery document listing authorization_code in grant_types_supported (served), else an oauth2 authorizationCode flow or openIdConnect declared in an OpenAPI (documented)
Typed Event Surface +6 pts — AsyncAPI document, OR webhooks/callbacks objects in the as-published OpenAPI, OR common[].type includes Webhooks

5 more unmet checks in the Agent Readiness table above.

Kin Score — facets with the most composite points still available (weight × headroom):

Access Clarity scores 5.3 — up to +18.9 composite points
Developer Ergonomics scores 23.8 — up to +15.2 composite points
Operational Transparency scores 15.8 — up to +10.9 composite points

Each check links to what satisfies it. Publish the artifact, or tell us where it already lives, and the score moves on the next scoring run.

Improve this rating by publishing the missing artifacts — every area above can be raised, and the full rubric is at apis.io/rating/. Every facet and dimension name above is a link: it opens that measurement's own page — what it means, the exact checks that feed it, how the whole catalog distributes on it, and the providers at the top of it. This rating is computed from the provider profile at artifacts.apis.io/unitedhealth/apis.yml: open an issue on github.com/api-evangelist/unitedhealth to ask a question or point us at an artifact you publish. Submit an artifact on GitHub — free → Manage your own listing — the Influence plan, $499/mo →

Standards implemented 2

Standards this provider implements or carries. De facto ones are profiled and measured by the API Commons; formal ones come from the standards directory and are linked by the provider's own tags. The evidence column says how each claim was established — not that it was made.

HL7 FHIR

tagged — the provider's own APIs.json carries the standard as a tag; implementation not verified

OpenAPI

measured — observed by APIs.io (published)

APIs 4

Individual APIs this provider publishes, each with its own machine-readable definition.

UnitedHealth Group Clinical Data API

FHIR R4 clinical data including conditions, observations, and medications

UnitedHealth Group Drug Formulary API

FHIR R4 Drug Formulary API for prescription drug coverage information

UnitedHealth Group Patient Access API

FHIR R4 Patient Access API for member health data (CMS-9115-F)

UnitedHealth Group Provider Directory API

FHIR R4 Provider Directory API implementing Da Vinci PDex Plan Net IG

Open Collections 5

Open, tool-agnostic API collections (OpenAPI-derived and Bruno).

UnitedHealth Group Optum Clinical Data API

OPEN COLLECTION

UnitedHealth Group Optum Clinical Data Drug Formulary API

OPEN COLLECTION

UnitedHealth Group Optum API

OPEN COLLECTION

UnitedHealth Group Optum Clinical Data Patient Access API

OPEN COLLECTION

UnitedHealth Group Optum Clinical Data Provider Directory API

OPEN COLLECTION

UnitedHealth Group API pricing

Not yet checked against UnitedHealth Group's own pricing page. Compiled by API Evangelist on 2026-05-05 from developer.uhc.com; confirm before you rely on a figure.

Plan	Price
Contact Sales enterprise	—

Plan details, limits and sources →

Rate limits

Patient Access FHIR: see UHC / Optum developer portal app onboarding varies
Commercial integration: see Optum / UHC commercial agreement varies

Compiled by API Evangelist, not yet checked against UnitedHealth Group's documentation. Rate-limit details →

Pricing Plans 1

Published pricing tiers and plan structures.

Unitedhealth Plans Pricing

1 plans

PLANS

Rate Limits 1

Documented rate limits and quota policies.

Unitedhealth Rate Limits

2 limits

RATE LIMITS

Service Levels 1

Uptime the provider promises or reports, as SLA4OAI. Read from its own pages; APIs.io runs no monitors.

UnitedHealth Group

SLA

FinOps 1

Cost, billing, and metering signals for API financial operations.

Unitedhealth Finops

FINOPS

Semantic Vocabularies 1

JSON-LD contexts and semantic vocabularies used across these APIs.

Unitedhealth Optum Api Context

21 classes · 1 properties

JSON-LD

Spectral Rules 2

Spectral governance rulesets for linting and validating these APIs.

UnitedHealth Group — jsonschema rules

5 rules · 3 warnings 2 info

SPECTRAL

UnitedHealth Group API Rules

30 rules · 13 errors 13 warnings 4 info

SPECTRAL

JSON Schema 6

Standalone JSON Schema definitions for this provider's data models.

UnitedHealth Group FHIR Bundle

7 properties

JSON SCHEMA

UnitedHealth Group FHIR Coverage

11 properties

JSON SCHEMA

UnitedHealth Group FHIR ExplanationOfBenefit

11 properties

JSON SCHEMA

UnitedHealth Group FHIR MedicationKnowledge

9 properties

JSON SCHEMA

UnitedHealth Group FHIR Patient

8 properties

JSON SCHEMA

UnitedHealth Group FHIR Practitioner

8 properties

JSON SCHEMA

JSON Structure 6

JSON Structure definitions describing this provider's data shapes.

Optum Fhir Bundle Structure

0 properties

JSON STRUCTURE

Optum Fhir Coverage Structure

0 properties

JSON STRUCTURE

Optum Fhir Explanation Of Benefit Structure

0 properties

JSON STRUCTURE

Optum Fhir Medication Knowledge Structure

0 properties

JSON STRUCTURE

Optum Fhir Patient Structure

0 properties

JSON STRUCTURE

Optum Fhir Practitioner Structure

0 properties

JSON STRUCTURE

Examples 5

Example request and response payloads for these APIs.

Optum Fhir Bundle Example

7 fields

EXAMPLE

Optum Fhir Coverage Example

10 fields

EXAMPLE

Optum Fhir Medication Knowledge Example

7 fields

EXAMPLE

Optum Fhir Patient Example

10 fields

EXAMPLE

Optum Fhir Practitioner Example

8 fields

EXAMPLE

Security Posture 3

Authentication, domain security, vulnerability disclosure, and trust-center signals.

Unitedhealth Authentication

http · 1 scheme

SECURITY

Unitedhealth Domain Security

TLSv1.3 · DNSSEC · DMARC

SECURITY

Unitedhealth Vulnerability Disclosure

security.txt · contact published

SECURITY

Agentic Access 1

Recommended x-agentic-access execution contracts for AI agents.

Unitedhealth Agentic Access

7 operations

7 operations · 0 acting

AGENTIC

Resources

Agent Surfaces 1

MCP servers, agent skills, and machine-readable catalogs

AgenticAccess

AgenticAccess

Access & Security 3

Authentication, authorization, and security posture

VulnerabilityDisclosure

VulnerabilityDisclosure

DomainSecurity

DomainSecurity

Authentication

Authentication

Operate 1

Status, limits, changes, and where to get help

RateLimits

RateLimits

Commercial 2

Pricing, plans, and the legal terms of use

Plans

Plans

FinOps

FinOps

Company 2

The organization behind the API

Blog

Blog

LinkedIn

Other 1

Properties that don't map to a standard resource type

CapabilityMap

CapabilityMap

Source (apis.yml)

aid: unitedhealth
url: https://raw.githubusercontent.com/api-evangelist/unitedhealth/refs/heads/main/apis.yml
name: UnitedHealth Group
description: UnitedHealth Group is a diversified health care company with two distinct platforms, UnitedHealthcare for health
  benefits and Optum for health services, serving more than 100 million people worldwide. The company offers FHIR R4-compliant
  Interoperability APIs through the Optum platform, providing patient access to health records, claims history, provider directory,
  and drug formulary data in compliance with CMS Interoperability and Patient Access final rule (CMS-9115-F) and HL7 FHIR
  standards.
tags:
- Healthcare
- Health Insurance
- FHIR
- Claims
- Interoperability
- Fortune 100
kind: company
deliveryModel:
  model: unknown
  open_source: false
  commercial: false
  callable_host: false
  label: Delivery model not determined — needs a product licence on record
  confidence: low
  source:
  - openapi
  generated: '2026-08-28'
  method: derived
accessModel:
  pricing: enterprise
  onboarding: unknown
  trial: false
  try_now: false
  public: false
  label: Enterprise
  confidence: medium
  source:
  - plans
  - authentication
  - security
  generated: '2026-11-06'
  method: derived
image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/icons/unitedhealth.png
access: 3rd-Party
created: '2026-03-21'
modified: '2026-10-06'
position: Consuming
specificationVersion: '0.23'
common:
- type: Plans
  url: plans/unitedhealth-plans-pricing.yml
- type: RateLimits
  url: rate-limits/unitedhealth-rate-limits.yml
- type: FinOps
  url: finops/unitedhealth-finops.yml
- url: https://www.uhc.com/news-articles/newsroom?cid=vanity-news
  type: Blog
- type: CapabilityMap
  url: capabilities/unitedhealth-capability-edges.yml
  name: UnitedHealth Group Business Capability Map
- type: AgenticAccess
  url: agentic-access/unitedhealth-agentic-access.yml
- type: VulnerabilityDisclosure
  url: security/unitedhealth-vulnerability-disclosure.yml
- type: DomainSecurity
  url: security/unitedhealth-domain-security.yml
- type: Authentication
  url: authentication/unitedhealth-authentication.yml
- type: LinkedIn
  url: https://www.linkedin.com/company/unitedhealth-group
apis:
- aid: unitedhealth:unitedhealth-clinical-data-api
  name: UnitedHealth Group Clinical Data API
  description: FHIR R4 clinical data including conditions, observations, and medications
  humanURL: https://www.uhc.com/legal/interoperability-apis
  baseURL: https://api.uhc.com/fhir/R4
  tags:
  - Clinical Data
  properties:
  - type: OpenAPI
    url: openapi/unitedhealth-clinical-data-api-openapi.yml
  - type: Documentation
    url: https://www.uhc.com/legal/interoperability-apis
  - type: Schema
    url: json-schema/optum-fhir-bundle-schema.json
  - type: Schema
    url: json-schema/optum-fhir-patient-schema.json
  - type: JSONLDContext
    url: json-ld/unitedhealth-optum-api-context.jsonld
  - type: Examples
    url: examples/optum-fhir-patient-example.json
- aid: unitedhealth:unitedhealth-drug-formulary-api
  name: UnitedHealth Group Drug Formulary API
  description: FHIR R4 Drug Formulary API for prescription drug coverage information
  humanURL: https://www.uhc.com/legal/interoperability-apis
  baseURL: https://api.uhc.com/fhir/R4
  tags:
  - Drug Formulary
  properties:
  - type: OpenAPI
    url: openapi/unitedhealth-drug-formulary-api-openapi.yml
  - type: Documentation
    url: https://www.uhc.com/legal/interoperability-apis
  - type: Schema
    url: json-schema/optum-fhir-bundle-schema.json
  - type: Schema
    url: json-schema/optum-fhir-patient-schema.json
  - type: JSONLDContext
    url: json-ld/unitedhealth-optum-api-context.jsonld
  - type: Examples
    url: examples/optum-fhir-patient-example.json
- aid: unitedhealth:unitedhealth-patient-access-api
  name: UnitedHealth Group Patient Access API
  description: FHIR R4 Patient Access API for member health data (CMS-9115-F)
  humanURL: https://www.uhc.com/legal/interoperability-apis
  baseURL: https://api.uhc.com/fhir/R4
  tags:
  - Patient Access
  properties:
  - type: OpenAPI
    url: openapi/unitedhealth-patient-access-api-openapi.yml
  - type: Documentation
    url: https://www.uhc.com/legal/interoperability-apis
  - type: Schema
    url: json-schema/optum-fhir-bundle-schema.json
  - type: Schema
    url: json-schema/optum-fhir-patient-schema.json
  - type: JSONLDContext
    url: json-ld/unitedhealth-optum-api-context.jsonld
  - type: Examples
    url: examples/optum-fhir-patient-example.json
- aid: unitedhealth:unitedhealth-provider-directory-api
  name: UnitedHealth Group Provider Directory API
  description: FHIR R4 Provider Directory API implementing Da Vinci PDex Plan Net IG
  humanURL: https://www.uhc.com/legal/interoperability-apis
  baseURL: https://api.uhc.com/fhir/R4
  tags:
  - Provider Directory
  properties:
  - type: OpenAPI
    url: openapi/unitedhealth-provider-directory-api-openapi.yml
  - type: Documentation
    url: https://www.uhc.com/legal/interoperability-apis
  - type: Schema
    url: json-schema/optum-fhir-bundle-schema.json
  - type: Schema
    url: json-schema/optum-fhir-patient-schema.json
  - type: JSONLDContext
    url: json-ld/unitedhealth-optum-api-context.jsonld
  - type: Examples
    url: examples/optum-fhir-patient-example.json
features:
- name: FHIR R4 Patient Access API
  description: CMS-mandated FHIR R4 Patient Access API providing members and third-party applications with access to claims,
    EOBs, coverage details, and clinical data.
- name: Provider Directory API
  description: FHIR R4 Provider Directory implementing Da Vinci PDex Plan Net IG for searching UnitedHealth Group network
    practitioners and organizations.
- name: Drug Formulary API
  description: FHIR R4 Drug Formulary API implementing Da Vinci Drug Formulary IG for accessing prescription drug coverage
    tiers, prior auth requirements, and quantity limits.
- name: Claims History Access
  description: FHIR ExplanationOfBenefit resources providing comprehensive claims history including service details, diagnosis
    codes, and payment adjudication.
- name: Clinical Data Exchange
  description: FHIR Condition and clinical data resources for member health history as reflected in claims and available clinical
    records.
- name: Coverage Information
  description: FHIR Coverage resources for current and historical insurance coverage details across UnitedHealthcare commercial,
    Medicare, and Medicaid plans.
useCases:
- name: Patient Portal Health Data
  description: Enable patient portals to display complete health records including claims, coverage, and conditions using
    FHIR Patient Access APIs.
- name: Care Coordination Apps
  description: Build care management tools that aggregate member health history, coverage, and clinical data for population
    health management.
- name: Provider Network Search
  description: Develop provider search applications using the FHIR Provider Directory to help members find in-network physicians
    and specialists.
- name: Prescription Benefit Transparency
  description: Integrate drug formulary data into clinical and patient-facing applications to show coverage tiers and prior
    authorization requirements.
- name: CMS Compliance Applications
  description: Build CMS-compliant third-party applications leveraging UnitedHealth Group's FHIR R4 interoperability infrastructure
    for data portability.
- name: Claims Analytics
  description: Access structured claims data as FHIR ExplanationOfBenefit resources for population health analytics and care
    gap identification.
integrations:
- name: Apple Health Records
  description: UnitedHealth Group FHIR Patient Access API integrates with Apple Health Records for member health data access
    on iOS devices.
- name: CommonWell Health Alliance
  description: UnitedHealth Group participates in CommonWell for FHIR-based health information exchange across provider networks.
- name: Carequality
  description: FHIR data exchange integration through Carequality framework for nationwide health information network connectivity.
- name: Da Vinci Project
  description: UnitedHealth Group implements Da Vinci IGs for payer data exchange including PDex Plan Net for provider directory
    and Drug Formulary IG.
artifacts:
  openapi:
  - name: UnitedHealth Group Optum API
    url: openapi/unitedhealth-optum-api-openapi.yml
  jsonSchema:
  - url: json-schema/optum-fhir-bundle-schema.json
  - url: json-schema/optum-fhir-patient-schema.json
  - url: json-schema/optum-fhir-explanation-of-benefit-schema.json
  - url: json-schema/optum-fhir-coverage-schema.json
  - url: json-schema/optum-fhir-practitioner-schema.json
  - url: json-schema/optum-fhir-medication-knowledge-schema.json
  jsonStructure:
  - url: json-structure/optum-fhir-bundle-structure.json
  - url: json-structure/optum-fhir-patient-structure.json
  - url: json-structure/optum-fhir-explanation-of-benefit-structure.json
  - url: json-structure/optum-fhir-coverage-structure.json
  - url: json-structure/optum-fhir-practitioner-structure.json
  - url: json-structure/optum-fhir-medication-knowledge-structure.json
  jsonLd:
  - url: json-ld/unitedhealth-optum-api-context.jsonld
  examples:
  - url: examples/optum-fhir-patient-example.json
  - url: examples/optum-fhir-bundle-example.json
  - url: examples/optum-fhir-coverage-example.json
  - url: examples/optum-fhir-practitioner-example.json
  - url: examples/optum-fhir-medication-knowledge-example.json
  spectralRules:
  - url: rules/unitedhealth-spectral-rules.yml
  capabilities:
    shared:
    - url: capabilities/shared/optum-api.yaml
    workflows:
    - url: capabilities/health-data-interoperability.yaml
  vocabulary:
  - url: vocabulary/unitedhealth-vocabulary.yaml
maintainers:
- FN: Kin Lane
  email: kin@apievangelist.com

UnitedHealth Group API — frequently asked questions

Does UnitedHealth Group have an API?

Yes. APIs.io lists 4 APIs from UnitedHealth Group, including UnitedHealth Group Clinical Data API, UnitedHealth Group Drug Formulary API and UnitedHealth Group Patient Access API, and 1 more.

Is there an OpenAPI specification for the UnitedHealth Group API?

Yes. APIs.io indexes 4 OpenAPI specifications for UnitedHealth Group, each linked for download from this page.

How do I authenticate with the UnitedHealth Group API?

UnitedHealth Group uses bearer-token authentication (http · 1 scheme). The details are profiled on APIs.io as Unitedhealth Authentication.

How much does the UnitedHealth Group API cost?

APIs.io lists 1 pricing plan for UnitedHealth Group, with each plan's price, limits and inclusions under Pricing on this page.

Is the UnitedHealth Group API ready for AI agents?

UnitedHealth Group has a Kin Score of 30.9 out of 100 (thin) and an Agent Readiness score of 24.1 (agent-aware), scored by API Evangelist on 2026-11-06.

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Tools for providers

9 MCP tools reach this

find_providersBrowse and filter every provider in the catalog.
get_provider_artifactsEvery artifact this provider publishes, grouped by type.
get_provider_operationsEvery operation across all of their OpenAPIs — one call instead of parsing every spec.
get_provider_toolsEvery MCP tool they ship, with the operation each wraps.
get_provider_evidenceHow each part of their score was established. Free — the basis for a claim should not sit behind it.
get_provider_ratingPRO — composite, band, trend and facet scores.
apis_io_searchSTART HERE — APIs, providers and tags for one query, each with its total.
resolveTurn a domain, URL or GitHub org into the provider it belongs to.
find_cohortsEvery scored population of providers in the catalog.

All 92 tools →

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